Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Texas (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Staci Wilson (NPI 1598163511)

Field	Value
Entity Type	Individual
Organization	Staci Wilson
Address	13212 Lone Creek Ln
City	Pearland
State	TX
ZIP	77584
Taxonomy	Low Vision Occupational Therapist
NPI Enumerated	December 8, 2014

Payer Source	Total Paid
Medicare	$39.5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	1,930	$20	$38.5K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	20	$80	$1.6K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Staci Wilson — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	3	490	60	$20	$3.2K
97167	12	20	20	$80	$2.5K

Nearby Providers

Other providers in the same ZIP code as Staci Wilson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrity Health Group, Inc.	TX	Home Health Agency	$0	$12.5M
Apc Health LLC	TX	Clinical Medical Laboratory	$600.6K	$2.3M
Larry Puthenparambil	TX	Retina Specialist (Ophthalmology) Physician	$1M	$0
Anna Drosou	TX	MOHS-Micrographic Surgery Physician	$588.5K	$0
Steven Pulley	TX	Interventional Pain Medicine Physician	$202.5K	$137.8K
Carl Fastabend	TX	Cardiovascular Disease Physician	$226.8K	$0
Alpesh Shah	TX	Interventional Cardiology Physician	$223.6K	$0
Jay Lafleur	TX	Interventional Pain Medicine Physician	$221.7K	$0
Sunrise Labs Tx	TX	Clinical Medical Laboratory	$219.8K	$0
Robert Burke	TX	Sports Medicine (Orthopaedic Surgery) Physician	$192K	$0

Staci Wilson — Billing Profile & Reimbursement Data

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Staci Wilson — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References